BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MBT FOOTWEAR

    MDR report key: 2546139 · Received April 18, 2012

    Report

    Report Number
    3009089619-2012-00002
    Event Type
    Injury
    Date Received
    April 18, 2012
    Date of Event
    November 8, 2010
    Manufacturer
    MASAI MARKETING + TRADING AG
    Product Code
    KNP
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    AFTER WEARING THE SHOES FOR 3 WEEKS SHE STARTED HAVING LEG AND FOOT PAIN, THEN LOW BACK AND HIP PAIN. TWO MONTHS LATER SHE WENT TO THE ER AND WAS "TAKEN OFF WORK" AND DIAGNOSED WITH A LUMBAR "COLLAPSED DISC."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MBT FOOTWEAR ORTHOSES, CORRECTIVE SHOE KNP MASAI MARKETING + TRADING AG UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Other